卵巢子宫内膜异位囊肿组织中Bax、Bcl-2蛋白表达与超声引导下聚桂醇介入术后复发的关系分析-现代医学

卵巢子宫内膜异位囊肿组织中Bax、Bcl-2蛋白表达与超声引导下聚桂醇介入术后复发的关系分析

单位：1. 北京核工业医院超声科, 北京 100045;
2. 北京核工业医院护理部, 北京 100045

分类号：R711.75

出版年·卷·期（页码）：2022·50·第一期（47-52）

摘要：

目的：观察卵巢子宫内膜异位囊肿组织中B淋巴细胞瘤-2相关X(Bax)、B淋巴细胞瘤-2(Bcl-2)蛋白表达，并分析其与超声引导下聚桂醇介入术后复发的关系。方法：回顾性分析221例卵巢子宫内膜异位囊肿实施超声引导下聚桂醇介入术治疗的患者的资料，术中均取囊肿组织，记为研究组；另回顾性分析206例良性病变患者的资料，均经活检穿刺术取卵巢子宫内膜组织并有石蜡存档标本，记为对照组。采用免疫组化法检测2组组织中Bax、Bcl-2蛋白表达；对研究组随访3年，对比复发和未复发患者囊肿组织Bax、Bcl-2蛋白阳性表达率；采用Logistic多元回归分析探讨Bax、Bcl-2蛋白表达与研究组复发的关系。结果：研究组增生期、分泌期Bax蛋白阳性表达率及总阳性表达率均低于对照组，Bcl-2蛋白阳性表达率均高于对照组，差异均有统计学意义(P＜0.05)；研究组复发率为22.17%，复发患者囊壁厚度≥0.3 cm，入院时血清CA125阳性，Bax蛋白阴性表达率、Bcl-2蛋白阳性表达率均高于未复发患者，差异均有统计学意义(P＜0.05)，且Logistic多元回归分析证实以上变量均为研究组复发的独立危险因素。结论：在卵巢子宫内膜异位囊肿组织中Bax蛋白阳性表达率低，Bcl-2蛋白阳性表达率高，且Bax蛋白阴性表达、Bcl-2蛋白阳性表达与囊壁厚度≥0.3 cm和入院时血清CA125阳性等均可增加超声引导下聚桂醇介入术后复发的风险。

Objective: To observe the expressions of B-lymphoma-2-related X(Bax) and B-lymphoma-2(Bcl-2) proteins in ovarian endometriosis cysts, and to analyze their relationships with the recurrence after ultrasound guided lauromacrogol intervention. Methods: The data of 221 cases of ovarian endometriosis cyst treated by ultrasound guided lauromacrogol intervention were retrospectively analyzed. In addition, the data of 206 patients with benign lesions were retrospectively analyzed. The ovarian endometrial tissues were obtained by biopsy and the paraffin embedded specimens were recorded as the control group. The expressions of Bax and Bcl-2 proteins were detected by immunohistochemistry. The study group was followed up for 3 years to compare the positive expression rates of Bax and Bcl-2 proteins between recurrent and non recurrent cysts. The relationships between the expressions of Bax and Bcl-2 proteins and the recurrence of the study group were analyzed by Logistic multiple regression analysis. Results: The positive expression rates of Bax protein in proliferative and secretory phase and total positive expression rate of study group were lower than those of control group, and the positive expression rates of Bcl-2 protein were higher than those of control group with statistically significant differences(P<0.05). The recurrence rate of the study group was 22.17%. The proportions of recurrent patients with cyst wall thickness≥0.3 cm, serum CA125 positive, negative expression rate of Bax protein and positive expression rate of Bcl-2 protein were higher in patients with recurrence than those without recurrence with statistically significant differences(P<0.05). Logistic multiple regression analysis confirmed that the above variables were independent risk factors for recurrence in the study group. Conclusion: Low positive rate of Bax protein and high Bcl-2 positive expression in ovarian endometriosis cyst tissue, and negative Bax expression plus positive Bcl-2 protein and with cyst wall≥0.3 cm, and positive serum CA125 at admission can increase the risk of recurrence after ultrasound-guided polyguiol intervention.

参考文献：

[1] 陈欣，刘海元，郎景和，等.手术前GnRH-a治疗对卵巢子宫内膜异位囊肿患者手术后自然妊娠的影响[J].中华妇产科杂志，2018，53(10)：683-688.
[2] 戴毅，张俊吉，郎景和，等.2018年子宫内膜异位症诊治现状方便抽样调查报告[J].中华妇产科杂志，2020，55(6)：402-407.
[3] 张亚楠，王冬颖，白符，等.2019年中国辅助生殖机构首诊女性生育力评价的现况分析[J].中华预防医学杂志，2020，54(5)：566-568.
[4] NOWAK-PSIORZ I,CIEĆWIEŹ S M,BRODOWSKA A,et al.Treatment of ovarian endometrial cysts in the context of recurrence and fertility[J].Adv Clin Exp Med,2019,28(3):407-413.
[5] 黄静，吴淑梅.卵巢子宫内膜异位囊肿术后应用促性腺激素释放激素药物预防复发[J].山西医药杂志，2020，49(12)：1577-1578.
[6] ZHU G,KONG J,FU X,et al.Identification of differentially expressed proteins associated with recurrence in ovarian endometriotic cysts[J].Syst Biol Reprod Med,2020,66(1):59-69.
[7] LI S,ZHU Y,ZHANG T,et al.Cai's neiyi prescription promotes apoptosis and inhibits inflammation in endometrial stromal cells with endometriosis through inhibiting USP10[J].Biotechnol Appl Biochem,2019,66(2):231-239.
[8] BANAS T,PITYNSKI K,MIKOS M,et al.Endometrial polyps and benign endometrial hyperplasia have increased prevalence of DNA fragmentation factors 40 and 45(DFF40 and DFF45) together with the antiapoptotic B-Cell lymphoma(Bcl-2) protein compared with normal human endometria[J].Int J Gynecol Pathol,2018,37(5):431-440.
[9] 蔡俊杰.免疫组化阳性或阴性的评判标准及相关问题的探讨[J].中华现代医学与临床，2005，2(4)：13-14.
[10] TAN D A,ALMARIA M J G.Postmenopausal endometriosis:drawing a clearer clinical picture[J].Climacteric,2018,21(3):249-255.
[11] OZYUREK E S,YOLDEMIR T,KALKAN U.Surgical challenges in the treatment of perimenopausal and postmenopausal endometriosis[J].Climacteric,2018,21(4):385-390.
[12] SAHIN H,SARI M E,CUYLAN Z F,et al.Is the presence ofendometriosis associated with a survival benefit in pure ovarian clear cell carcinoma?[J].Arch Gynecol Obstet,2018,297(4):1005-1013.
[13] 洪艺煌.卵巢子宫内膜异位囊肿剥除术后复发相关因素的探索[D].厦门：厦门大学,2018.
[14] 龚曌，刘明辉.超声引导介入治疗卵巢子宫内膜异位囊肿的疗效评估[J].中国医学物理学杂志，2018，35(3)：292-295.
[15] PARK S,LIM W,BAZER F W,et al.Apigenin induces ROS-dependent apoptosis and ER stress in human endometriosis cells[J].J Cell Physiol,2018,233(4):3055-3065.
[16] 钟三姣，刘利平.TLR4通路与子宫内膜异位症病灶内细胞异常增殖、侵袭的相关性分析[J].中国妇幼保健，2019，34(14)：3345-3348.
[17] YANG H L,CHANG K K,MEI J,et al.Estrogen restricts the apoptosis of endometrial stromal cells by promoting TSLP secretion[J].Mol Med Rep,2018,18(5):4410-4416.
[18] 严必红，曾为红.Bcl2相互作用蛋白3在子宫内膜组织中的表达及其在子宫内膜异位症发病中的意义[J].安徽医药，2020，24(1)：136-140.
[19] MIRAKHOR S S,EZAZI B T,ZARGHAMPOUR M,et al.Expression of p53,Bcl-2 and Bax in endometrial carcinoma,endometrial hyperplasia and normal endometrium:a histopathological study[J].J Obstet Gynaecol,2018,38(7):999-1004.
[20] NAHARI E,RAZI M.Silymarin amplifies apoptosis in ectopic endometrial tissue in rats with endometriosis:implication on growth factor GDNF,ERK1/2 and Bcl-6b expression[J].Acta Histochem,2018,120(8):757-767.
[21] 张美龄，韩凤贤，周冰.卵巢子宫内膜异位囊肿腹腔镜手术后复发的多因素Logistic分析[J].中国医师杂志，2019，21(3)：436-438.

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